FEATURE


ect in July 2014,” she says. “We tried to stay on task, but you have to plan for some changes. Our original plan was to be done by April 1, but we needed two extra months. We knew from the begin- ning that this timeline was subject to change depending on what happened.”


Expanding and Remodeling


Requirements and considerations for ASCs BY ROBERT KURTZ


M


any factors come into play during an ASC expansion and remodeling


project, says John Marasco, principal and owner of Marasco & Associates, a health care architecture and consult- ing firm based in Denver, Colorado. “That is why it is imperative to take your time, determine the phases of construction and the domino effect that will follow once you begin. Have all of your ducks in a row before you start the project.” Jeffrey Simmons, chief develop- ment officer for ASC management and development company Regent Sur- gical


Health, based in Westchester,


Illinois, says that a steady, patient approach works best. “You have to be really obsessive in going through the different phases to make sure every- thing you want to do is completed appropriately,” he says. “You should have a checklist, and make sure you complete every item on it.”


16 ASC FOCUS SEPTEMBER 2015


You should hire an architect who has worked on ASCs before—and preferably ASCs in your state—so they know both the state laws and Medicare rules.”


— Jeffrey Simmons Regent Surgical Health


For Northwest Michigan Surgery


Center in Traverse City, Michigan, which completed a $1.6 million remodeling and expansion at the end of May, developing a timeline was critical, as was maintaining flexibility around it, says LoAnn Vande Leest, RN, CASC, administrator and chief executive officer of the ASC. “Our timeline showed every step of our plan and how long it was projected to take from when we started the proj-


Do Your Due Diligence Before beginning any work on the building, Marasco advises ASCs to involve state health department repre- sentatives. “Sit down for a preliminary review with them to make sure you are on the same page as far as what codes you are required to meet and issues that may come up that you will need to address. The primary issues an ASC is likely going to face involve the cur- rent codes that exist both from the Cen- ters for Medicare & Medicaid Services (CMS) and the state health department. “From a federal and state perspec-


tive, the state health department will make sure your facility is up to code,” he says. “They really control the suc- cessful outcome of the ASC project, so talk to them early and frequently to make sure you meet expectations.” Vande Leest found this step to be crit- ical to her project’s success. “We brought the state architect in and gave him an idea of the things we wanted to do to get his thoughts. We wanted to make sure our plan was going to fly before we began.” Simmons says it is important to


work with individuals who have knowl- edge of your state’s rules. “You should hire an architect who has worked on ASCs before—and preferably ASCs in your state—so they know both the state laws and Medicare rules. It may not be the same architect that con- structed your original facility.”


Understand Impact “You have to look at how an expansion will impact your ASC in the total sense,” Marasco says.


“If you are


going to add an operating room (OR), is your waiting room, pre- and postop,


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